翻修全肩关节置换术后早期非计划再手术的患者相关风险因素

Ralph Alberto, Apoorva H Mehta, Puneet Gupta, Emily Arciero, Kunj G Patel, David P. Trofa
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引用次数: 0

摘要

随着初次手术数量的快速增长,全肩关节置换术(TSA)翻修手术的数量也在增加。翻修手术的失败率较高,而且人们对翻修 TSA 后需要再次手术的患者风险因素缺乏了解。我们将翻修患者分为两组:翻修 TSA 术后 30 天内需要意外再次手术的患者和不需要再次手术的患者。通过多变量逻辑回归来确定意外再次手术的独立风险因素。最终分析共纳入了 1909 名翻修 TSA 患者。其中 69 名患者在 30 天内接受了意外再手术,1840 名患者没有。多变量逻辑回归分析发现,ASA III 级或 IV 级、男性、充血性心力衰竭和住院环境是独立的风险因素。3.6%的TSA翻修患者在术后30天内需要进行计划外再次手术。ASA分级为III级或IV级、男性、充血性心力衰竭和住院环境是早期再次手术的独立风险因素。外科医生应该意识到这些风险,以改善患者的术前优化,并指导考虑翻修的患者共同做出决定。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Patient-related risk factors for early unplanned reoperation following revision total shoulder arthroplasty
There has been an increase in the number of total shoulder arthroplasty (TSA) revisions performed as the number of primary surgeries increases rapidly. Revision procedures have a higher failure rate and there is a lack of understanding of patient risk factors for needing another repeat surgery following revision TSA. Revision patients were separated into two cohorts: those needing an unplanned reoperation and those that did not within 30 days following revision TSA. Multivariate logistic regression was performed to identify independent risk factors for an unplanned reoperation. 1909 revision TSA patients were included in the final analysis. Sixty-nine of these patients underwent an unplanned reoperation within 30 days and 1840 did not. Multivariate logistic regression analyses found an ASA class of III or IV, male sex, congestive heart failure, and inpatient setting to be independent risk factors. 3.6% of revision TSA patients require an unplanned reoperation within 30 days postoperatively. An ASA class of III or IV, male sex, congestive heart failure, and inpatient setting were found to be independent risk factors for early reoperation. Surgeons should be aware of these risks to improve preoperative patient optimization and guide shared decision making with patients considering revision.
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